Improvement in trusses for the cure of prolapsus uteri



`UNITED STATES PATENT OFFICE.

AMOS GERALD HULL, OF NEW YORK, N. Y., ASSIGNEE OF JOHN F. GRAY,

ADMINISTRATOI- OF AMOS G. HULL, DECEASED.

'IMPROVEMENT IN TRUSSES FOR THE CURE 0F PROLAPSUS UTERI.

Spoclieation forming part of Letters Patent dated May 7, 1834; RclssueNo. l 2., dated September 14, 1839.

T0 all whom, ri may concern:

Be it known that AMos G. HULL, late of the city of New York, deceased,did invent a surgical apparatus for the relief and cure of procidentiaand p rolapsis uteri and other diseases dependent on relaxation oi' theviseera of the pelvis, otherwise known as Dn A. G. Hulls Utero-AbdominalSupporter,7 for which invention Letters Patent were granted to saidAires G. HULL bearing date the 7th day of May, in the year 1831i. SaidLetters Patent were assigned to me, ANOS GERALD HULL, by J ouN F. GRAY,administrator of the estate of the said Amos G. HULL, deceased; and Iherewith su rrcndcr the same on account of defective spccilication,oii'cring the following description in amendment thereof:

A surgical apparatus for the cure of falling of the womb, (or prolapsusproeidentianteri,) which apparatus said Anios G. HULL did make and vendby the name of Utero-Abdominal Supporter. The inventor of this apparatusdiseov ered that pressure made upon or against the lower part oftheabodomen, in manner and by means substantially the same as hereindescribed, does always relieve, and very often eiiectually cure, themalady in females commonly called falling ofthe womb.77 Before thediscovery of this apparatus the malady was treated in the last resort bythe introduction of props or blocks into the vagina (pas` sage leadingto the womb) to prevent the womb from falling down or from being presseddown and out through said vagina. These props, however constructed, werecalled pessaries. membrane with which it is in perpetual contact,sometimes causing inllammation, ulceration, and even death, and at bestit is a merely palliative expedient, tending rather to perpetuate thanto cause a removal of the prolapsus by distending the vagina andtormenting the patient. Hence it occurred that bei'ore the date of thisinvention coniirmed prolapsus was considered incurable, resistingmedical treatment, and subjecting the sublject of it to the unhappynecessity of wearing pessaries during the remainder of her days.

This apparatus, instead of propping up the womb from below, as thepessary does, hasits main pressure above the site of that organ,

The iessar irritates the delicate` above the hypogastric portion of theabdomen, and operates, as the inventor supposed, by counteracting thedepressing forces of the diaphragm and upper part of the belly torelieve the womb from the weight of the intestines above it, wherebyitwas pushed down and extruded from the lower outlet of the pelvis. Theinventor also thought that by pressing the hypogastriuxn obliquelyupward and backward it might render the peritoneal connections of theuterus tense, and thus raise it to or suspend it in its place by alifting process. However other surgeons might explain the principle uponwhiclthe apparatus cured the prolapsus, the inventor claimed to be thediscoverer of the means by which such salutary result was eected.

Description of the utero abdominal supporter: This apparatus consists,in part, of a hypogastric pad, a a a a, Figure l, made of such size andshape as to adapt it accurately to all that part of the moving frontwall ofthe belly lying below aline subtended between the anterior andsuperior processes of the iliac boues of the pelvis. This space, whichde fines the size and shape of the hypogastrie pad, is bound below bythe pubes, and at the sides by the upright margins of the iliac orhauneh bones. This pad lis therefore of an irregular' cordiform shape,much dilated laterally, and indented on its lower or pubic margiu tocorrespond to the shape of the upper line ot' the pubes, against whichit rests. The position of this pad when applied is exhibited in Fig. 3.

This pad (the hypogastric) is made of a thin plate of -inetal or othersuitable material, divided near its vertical axis into two wings by ahinge eontrivance, as seen in Fig. 4, which represents the pad-plate ofits ordinary size. The object of this hinge contrvanee is to give to theinner or belly aspect of the whole pad a form which approaches that of adouble inclined plane, the angle of which double plane may be increasedor diminished to any desirable or necessary extent with facility,without removing the apparatus from the patient, by means hereinafternamed. The plate of the hypogastric pad may also, in some eases, be madeentire without the hinge. The padplate, whether hinged or not, iscovered with pad, and

' segment, or half of cloth and leather, or either, and wadded on itsinner aspect, so as to make a proper cushion for the belly of thepatient.

The utero'abdominal supporter further consists of a steel spring, b b,Fig. 1, and a back pad, c, Fig. 1, like the springs and countc.- padsordinarily used in trusses for ruptures, in which the spring encompassesone-half the body and thc back pad rests on the spine of the patient.The spring is covered with cloth and leather or other suitable material.In front the spring crosses the center of the back or outer surface ofthe hypogastric pad, and terminates, as shown at f, Fig. 1, on the leftsegment or side of it, near the edge. The spring may be made fast at thecenter of the outer surface of the pad by means of a button-headedmortise, through which it should pass, or any convenient fixture. Insome instances it is desirable to make the strongest pressure by thelower or pubic portion of the hypogastric pad. To effect this the'rotary wedge of -Amos G. llulls truss for varicoeelc, patented July 5,1833, may be attached so as to play between the spring attachment to thepad and the back of the pad sce Figs. 1, 3, and 4) at a. In many casesit is found serviceable to make a much stronger pressure than can beconvenientl y derived from the spring alone,which may be effected byconveying a strap from t-he back or counter pad, c, around the side ofthe body opposite the spring b Z to the hypogastric pad, makin g acomplete elastic belt around the pelvis, as seen in Fig. 2, where saidstrap ff is divided into two thongs, g g, which are made fast by twoknobs on the back of said hypogastrie pad.

This apparatus further consists of a sliding wedge, d, Figs. 1 aud2intcrposed between the right segment of the hypogastric pad and thespring where it covers that part of the pad. The spring beinghoop-shaped, und terminating ou the left half of the pad, where itpresses much the strongest, this wedge cqualizes the pressure of the twosegments or halves of the when the vertical hinge in the pailplate isused, sliding this wedge forward or backward depresses or elevates theright wing, the pad, altering the eapacity of the inner' or belly aspectof the pad to suit the various and changing states of the hypogastricregion with respect to plumpuess or convcxity; and in ease the patientis so formed as that the front margins of the haunchbones projectconsiderably, as is apt to be the casein prolapsus of long standing, thecombined effect of this sliding wedge, the vertical hinge, and the freeend of the spring is to sink the right and left margins of the pad a a aa below the `level of said projecting haunchbones, making the innersurface of the pad in this case also correspond to the shape of thehypoga stric region under the various attitude r and states of the body.

In very full subjects the pad may be applied entire without the hinge.

The 'apparatus further consists, in some cases, of a contrivance forpressing the anoperineal region of the body (perineum) upward andforward, called perineal strap, .li h, Fig. 2. The perineal strapextends from the counter-pad c', Figs. 1 and 2,' to the hypogastricpall, traversing closely the ano-perineal region in .its course. Thisstra-p may be made of leather and cloth or other suitable material, andbe fastened to the pads aforesaid by knobs or other convenient fixtures,To the inner or perineal aspect of this strap is attached a cushion, i,Fig. 2, made of cloth and covered with oiled silk. rlhe cushion may beabout an inch thick at right angles with the strap, and it should be ofsuch length and so attached to the stmp as to press against all thespace lying between the tip of the es coccygis and the fourchette orlower endv of the vulva.

What is claimed in the within-described apparatus as the invention ofthe late AMes G. HULL is- The hypogastric pad a aa a and the cmploy- Vment thereof for the cure of prolapsns uteri,

the same being made and operating substantially as herein set forth;likewise the combination of the said hypogastric pad with the spring bb, the sliding wedge d, and the counter or back pad, c; and also thecombination of the perineal strap h h and cushion with thehypogastric'pad and its appendages, as herein described.

No separate part of this apparatus is claimed as new except the saidhypogastric pad; nor are any ox' the materials of which th 4everal partsof the apparatus are composee new or claimed as such in thisspecification.

AMOS GERALD HULL.

Witnesses:

Gno. BUTLER, Join: W. VAN BsNscno'rnN.

